Medication and Self-Care

Disclaimer: I must preface this with I am not a medical professional. I am not trying to tell anyone how to take their medications or to stop their medications by any means. This post is merely my opinion and experience with medication.

When I look at the top of my closet, I feel like I own a pharmacy or could start my own drug ring. Reading the labels across from left to right: Gabapentin 300mg three times a day, Celecoxib 200mg once a day, Vitamin D 50,000 SU (international units) once a week, Escitalopram 20mg once a day, Androgel 20.25 mcg two pumps daily. Right next to them are a multivitamin and Vitamin B supplement.

I will say that up until about five or six years ago I was extremely against the idea of taking medications. In high school, I had a horrible experience with the side effects of the antidepressant Effexor, which pretty much solidified this stance. However, I fell into a deep depressive episode in college. I was not doing well at all. I met with my primary care physician who recommended to start on a low dose of Lexapro. I reluctantly agreed to start on 5mg. They did not even make them that small at the time. She prescribed me 10mg, and I would cut them in half.

After about two months, I was not feeling any significant changes in my mood. I met with my doctor once more. She noticed a slight improvement during her assessment but not enough of one. My doctor wanted me to increase my dose to 10mg. With the increase, I felt like I was in a fog for about two weeks. This was normal unfortunately when adjusting to Lexapro. After the initial two weeks, I could see the change. The depressive symptoms were there but much more manageable. I stayed on this dose for about a year and half until some severe life stressors (i.e. relationship and family issues) got the better part of me. I had a nervous breakdown, and, consequently, a psychiatric hospitalization. I followed up with my primary care physician the week after my discharge. She wanted me to increase once more to 20mg. I was desperate to feel better, so I complied.

Other than the occasional antibiotic, Lexapro was my sole medication for over two years. I finally felt like I had control over my mental health, and was also seeing a counselor 2-4 times a month. Unfortunately, life had other plans for yours truly. This is when my physical health decided to backfire. I began experiencing chronic pain throughout my whole body, mostly in my joints, and extreme levels of fatigue. There were days I could not get out of bed for more than a few minutes at a time and missed weeks of work. It got to the point that I went to the emergency room. Even worse what that it took nearly six months to get a diagnosis. Between several visits to my family doctor, having multiple diagnostic tests turning up nothing, and seeing two rheumatologists, they ruled out everything. They ultimately diagnosed me with fibromyalgia. During the testing, they also found out that my testosterone levels were low. I went from my one antidepressant to the three medications. Another two would be added later.

As a 28-year-old male, it was extremely frustrating to know that my body was giving out on me. It happened at an age where an individual is meant to be in their peak physical shape. Also, being the independent person I am, I felt weak for depending on pills to survive day-to-day. Without them though, I might not be able to get out of bed due to depression, fatigue, or pain. This was my reality. I could continue to deny it or learn to accept it. With acknowledgment came a shift in attitude.

Working in the mental health field as both a case manager and counselor, I worked with psychiatrists, nurse practitioners, and clients with medical issues. This was before and during the development of my own issues. Many of the practitioners emphasized the importance of using the medications in conjunction with counseling and lifestyle changes. These practitioners often worked with their clients to keep them on the lowest dose possible. Some clients were even able to come off of their medications altogether if there was a significant enough improvement.

I decided to adopt this mentality. I first wanted to get a firm grasp on what was happening through educating myself and learning more about it. I would then implement the necessary changes and then ensure that my symptoms were stabilized. I met with professionals including doctors, personal trainers, a dietician, and therapists to name a few. I made adjustments to each area of my well-being and took into account the mind-body connection. I knew in the back of my mind that there was a chance that I might not come off of all my medications since some of my issues were chronic such as my low testosterone levels and fibromyalgia. However, I made it a goal to reduce my medication to a minimum in terms of overall number and dosages.

I waited until my physical, mental, and emotional health stabilized for close to six months to ensure that the success I experienced was maintainable and not just a fluke. Once I felt comfortable with it, I spoke to my doctors to get their opinion and guidance. (NEVER DO IT ON YOUR OWN! ALWAYS SPEAK TO A DOCTOR ABOUT MEDICATION CHANGES!) As we speak, I am down to taking my Gabapentin twice a day versus three times, and my Lexapro dose has been cut in half to 10mg to titrate off of it completely. I am also meeting with an endocrinologist to discuss alternatives for my low testosterone levels.

As annoying as medications can be, sometimes they are a necessity in order for someone to thrive. They can easily become part of one’s self-care. On the other hand, my self-care journey led to lifestyle changes. Those changes gave me the confidence and leverage to ultimately reduce my medications.